Related Experiment Video
Updated: Nov 8, 2025
Establishment of a Simple and Effective Rat Model for Intraoperative Parathyroid Gland Imaging
Published on: August 17, 2022
Pediatric hyperparathyroidism: review and imaging update
Hedieh Khalatbari1, Safia H E Cheeney2, Scott C Manning3
1Department of Radiology, University of Washington School of Medicine, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA. hedieh.khalatbari@seattlechildrens.org.
Insights
Pediatric hyperparathyroidism, characterized by excess parathyroid hormone, often presents with symptoms. Imaging like ultrasound and scintigraphy aids in localizing affected glands, crucial for diagnosis and treatment planning.
Area of Science:
- Endocrinology
- Pediatric Imaging
- Genetics
Background:
- Hyperparathyroidism involves elevated parathyroid hormone secretion, categorized as primary, secondary, or tertiary.
- Pediatric primary hyperparathyroidism frequently causes symptoms and can be linked to familial forms with genetic mutations.
- Accurate localization of hyperfunctioning parathyroid glands is essential for effective management.
Purpose of the Study:
- To review the embryology, anatomy, pathophysiology, and preoperative localization of parathyroid glands in pediatric hyperparathyroidism.
- To focus on imaging modalities and familial subtypes relevant to pediatric patients.
- To highlight differences and considerations compared to adult literature.
Main Methods:
- Review of parathyroid gland embryology, anatomy, and pathophysiology.
- Evaluation of first-line (scintigraphy, ultrasound) and second-line (CT, MRI) imaging modalities.
- Discussion of pediatric-specific considerations for imaging protocols and radiation dose optimization.
Main Results:
- Most symptomatic pediatric patients with sporadic primary hyperparathyroidism present with end-organ damage or nonspecific symptoms.
- Familial hyperparathyroidism, including calcium-sensing receptor gene mutations, is more prevalent in younger patients.
- Parathyroid scintigraphy and ultrasound are key initial imaging tools, complemented by CT and MRI for localization.
Conclusions:
- Preoperative localization of hyperfunctioning parathyroid glands is critical for managing pediatric hyperparathyroidism.
- Imaging principles for primary hyperparathyroidism localization are applicable to secondary and tertiary forms in pediatrics.
- Tailored imaging approaches, considering radiation safety, are vital for pediatric patients.
Abstract:
Hyperparathyroidism, due to increased secretion of parathyroid hormones, may be primary, secondary or tertiary. Most pediatric patients with sporadic primary hyperparathyroidism will be symptomatic, presenting with either end-organ damage or nonspecific symptoms. In younger patients with primary hyperparathyroidism, there is a higher prevalence of familial hyperparathyroidism including germline inactivating mutations of the calcium-sensing receptor genes that result in either neonatal severe hyperparathyroidism or familial hypocalciuric hypercalcemia. Parathyroid scintigraphy and ultrasound are complementary, first-line imaging modalities for localizing hyperfunctioning parathyroid glands. Second-line imaging modalities are multiphase computed tomography (CT) and magnetic resonance imaging. In pediatrics, multiphase CT protocols should be adjusted to optimize radiation dose. Although, the role of these imaging modalities is better established in preoperative localization of hyperfunctioning parathyroid glands in primary hyperparathyroidism, the same principles apply in secondary and tertiary hyperparathyroidism. In this manuscript, we will review the embryology, anatomy, pathophysiology and preoperative localization of parathyroid glands as well as several subtypes of primary familial hyperparathyroidism. While most of the recent imaging literature centers on adults, we will focus on the issues that are pertinent and applicable to pediatrics.
More Related Videos
Related Concept Videos
00:59The Parathyroid Glands
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
01:24Imaging Studies II: Ultrasonography
01:27Imaging Studies III: Computed Tomography
01:28Imaging Studies I: Kidney, Ureter, and Bladder Studies
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...